Investigation of the relationship between ocular sarcoidosis and dry eye

Abstract

A relationship between ocular sarcoidosis (OcSar) and dry eye (DE) has previously been reported. Here we investigated the tear function in OcSar, and the other uveitis, Vogt-Koyanagi-Harada disease (VKH), to elucidate the association between OcSar and DE. This study involved 27 eyes of 27 female OcSar patients [mean age: 67.3 ± 13.5 (SD) years], 18 eyes of 18 female VKH patients (53.1 ± 14.1 years), and 17 eyes of 17 female healthy control subjects (59.7 ± 9.6 years). In all examined eyes, tear meniscus height (TMH, mm), fluorescein breakup time (FBUT, s), scoring of keratoconjunctival epithelial damage (ED), and the Schirmer 1 test (ST1, mm/5 min) were analyzed. In the OcSar patients, VKH patients, and control subjects, the respective TMH, FBUT, ED, and ST1 values (mean ± SD) were 0.26 ± 0.10, 0.24 ± 0.09, and 0.24 ± 0.08, 4.3 ± 2.5, 7.3 ± 2.9, and 6.3 ± 3.1, 1.1 ± 1.1, 0.7 ± 0.8, and 0.1 ± 0.3, and 12.9 ± 10.5, 21.5 ± 12.1, and 24.3 ± 10.5. Statistically, the ST1 values were significantly lower in the OcSar patients than in the VKH patients (P = 0.004) and control subjects (P = 0.001). ST1 findings revealed that the neural reflex arc and lacrimal gland system, which attenuate the vicious cycle between the tear film and ocular surface epithelium in DE, are significantly impaired in OcSar cases, thus indicating a possible association between OcSar and DE.

Figure 1

(a) Comparison of tear meniscus height (TMH, mm) between the ocular sarcoidosis (OcSar) group (0.26 ± 0.10 mm), Vogt–Koyanagi–Harada disease (VKH) group (0.24 ± 0.09 mm), and normal control (NC) group (0.24 ± 0.08 mm) (all values are mean ± SD). No statistical difference was found. (b) Comparison of fluorescein breakup time (FBUT, seconds) between the OcSar group (4.3 ± 2.5 s), VKH group (7.3 ± 2.9 s) and OcSar group (6.3 ± 3.1 s) (all values are mean ± SD). Significant differences were found between the one of 3 groups [P = 0.002 (OcSar vs. VKH), P = 0.057 (OcSar vs. NC), and P = 0.527 (VKH vs. NC)]. (c) Comparison of keratoconjunctival epithelial damage (ED) between the OcSar group (1.1 ± 1.1), VKH group (0.7 ± 0.8), and NC group (0.1 ± 0.3) (all values are mean ± SD). There were significant differences between the two of 3 groups [P = 0.358 (OcSar vs. VKH), P = 0.001 (OcSar vs. NC), and P = 0.040 (VKH vs. NC)]. (d) Comparison of the Schirmer 1 test results (ST1, mm/5 min) between the OcSar group (12.9 ± 10.5 mm), VKH group (21.5 ± 12.1 mm), and NC group (24.3 ± 10.5 mm) (all values are mean ± SD). The ST1 values in the OcSar group were significantly lower than those in the VKH group and NC group [P = 0.004 (OcSar vs. VKH), P = 0.001 (OcSar vs. VKH)].